Breast cancer affects approximately 12.7 percent of women in the US, and women with a hereditary predisposition have a lifetime risk greater than 50 to 60 percent. Surveillance of these high-risk women is important for detecting invasive cancers early.Dr. Francesco Sardanelli from the University of Milan School of Medicine in Italy and his colleagues compared the sensitivity of clinical breast examinations, mammography, ultrasonography and contrast material-enhanced MRI for screening women at high risk of developing the cancer. As reported in the March issue of Radiology, 278 women who were carriers or first-degree relatives of carriers of the mutated genes BRCA1 or BRCA2 (associated with an increased chance of developing breast cancer at a young age) or who had a strong family history of breast or ovarian cancer were tested with the four detection methods in 17 clinical centers throughout Italy.Overall, the researchers diagnosed cancer in 11 patients during their first round of screening and in another seven during a second round. In the 18 patients who had breast cancer, six cancers were detected using only contrast-enhanced MR imaging. The other modalities required more than one technique to detect the cancers.The researchers believe that their results indicate that MRI should be considered as part of the screening process for high-risk women because it may enable detection of unsuspected cancers. The results are specific to genetic-familial high-risk women and cannot be translated to the general female population.